Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ 08901, USA.
Menopause. 2010 May-Jun;17(3):480-6. doi: 10.1097/gme.0b013e3181c1ac01.
The aim of this study was to study the efficacy and safety of ospemifene, a new selective estrogen receptor modulator, in the treatment of vulvovaginal atrophy in postmenopausal women.
A randomized, double-blind phase 3 study in which 826 postmenopausal women were randomized 1:1:1 to receive treatment with ospemifene 30 or 60 mg/day or placebo orally for 12 weeks was conducted. The primary inclusion criteria were having 5% or less superficial cells on the vaginal smear (maturation index), vaginal pH greater than 5.0, and at least one moderate or severe symptom of vulvovaginal atrophy. The four coprimary endpoints were the change from baseline to 12 weeks in the percentage of superficial and parabasal cells on the vaginal smear, change in vaginal pH, and change in severity of most bothersome symptom (vaginal dryness or dyspareunia) compared with placebo. All participants were given a nonhormonal vaginal lubricant for use as needed.
Ospemifene was statistically significantly superior to placebo in each of the coprimary endpoints at the 60-mg dose. Statistically significant results were achieved for all coprimary endpoints with the 30-mg dose except for dyspareunia. Ospemifene was well tolerated at both doses and demonstrated a favorable safety profile.
Ospemifene was shown to be effective and well tolerated for the treatment of the symptoms of vaginal dryness and dyspareunia associated with vulvovaginal atrophy over and above the use of provided lubricants.
本研究旨在研究新型选择性雌激素受体调节剂奥昔布芬治疗绝经后妇女阴道萎缩的疗效和安全性。
进行了一项随机、双盲的 3 期研究,826 名绝经后妇女被随机分为 1:1:1 组,分别接受奥昔布芬 30 或 60mg/天或安慰剂口服治疗 12 周。主要纳入标准为阴道涂片上有 5%或更少的表层细胞(成熟指数)、阴道 pH 值大于 5.0,以及至少有一个中度或重度阴道萎缩症状。四个主要次要终点是与安慰剂相比,阴道涂片上表层和副基底层细胞的百分比从基线到 12 周的变化、阴道 pH 值的变化以及最困扰症状(阴道干燥或性交困难)的严重程度变化。所有参与者都被给予非激素阴道润滑剂,需要时使用。
奥昔布芬在 60mg 剂量下在每个主要次要终点上均显著优于安慰剂。在 30mg 剂量下,除性交困难外,所有主要次要终点均达到统计学显著结果。奥昔布芬在两个剂量下均耐受良好,表现出良好的安全性。
奥昔布芬被证明对治疗与阴道萎缩相关的阴道干燥和性交困难症状有效且耐受性良好,优于提供的润滑剂的单独使用。